Background Robotic right colectomy is increasingly adopted for the management of right-sided colon cancer, offering enhanced visualization and instrument dexterity. This video aims to present a standardized, stepwise approach to robotic right colectomy with intracorporeal anastomosis, designed for surgical education and reproducibility. The procedure is indicated for patients with right-sided colon cancer suitable for minimally invasive resection. Technique and key steps A medial-to-lateral approach is employed using the Da Vinci Xi® platform. Key steps include trocar placement, central vascular ligation of the ileocolic vessels, retroperitoneal dissection with preservation of critical structures, mobilization of the hepatic flexure, and division of the right branch of the middle colic vessels. The resection corresponds to a D2 lymphadenectomy.Bowel continuity is restored using an intracorporeal isoperistaltic side-to-side anastomosis using a robotic stapler and barbed suture closure. Perfusion is assessed using indocyanine green fluorescence imaging prior to anastomosis. The video highlights key anatomical landmarks, technical considerations, and potential pitfalls, including safe dissection planes and protection of the ureter and duodenum. Take-home points This standardized approach emphasizes safety, clarity, and reproducibility, aligning with LAP-VEGaS guidelines for surgical video reporting. It provides a practical framework according to the IDEAL framework stage 2a – technical development for surgeons adopting robotic right colectomy while maintaining adherence to oncologic principles.

BackgroundSmall bowel obstruction (SBO) is a common surgical emergency. In transplant recipients, atypical etiologies may delay diagnosis and lead to suboptimal management.MethodsWe report a case of phytobezoar-induced SBO in a liver transplant recipient and conducted a focused narrative literature review (PubMed/MEDLINE, Embase, Cochrane Library, Google Scholar, OpenEvidence, Litmaps) of adult transplant patients with mechanical SBO reported up to January 2026.ResultsA 60-year-old man with two prior liver transplantations (2012, 2022) presented with acute abdominal pain and vomiting after ingestion of wild mushrooms. Initial contrast-enhanced CT suggested adhesional SBO. After failure of conservative management, exploratory laparoscopy identified an intraluminal mass in the distal jejunum. Mini-laparotomy with enterotomy allowed extraction of a phytobezoar composed of Craterellus cornucopioides. Despite marked bowel congestion and equivocal conventional viability criteria, intraoperative indocyanine green (ICG) fluorescence confirmed adequate perfusion and avoided resection. Postoperative course was complicated by paralytic ileus, successfully reversed with neostigmine. The patient was discharged on postoperative day 14. The literature review retrieved one retrospective study and seven adult case reports; bezoars accounted for 5/7 cases, predominantly located at Roux-en-Y enteric anastomoses. ICG fluorescence had not been used in any previously reported case.ConclusionBezoars are a rare but clinically relevant cause of SBO in transplant recipients. Early surgical exploration is warranted when conservative management fails or imaging is ambiguous. Intraoperative ICG fluorescence is a useful adjunct to assess bowel viability and may avoid unnecessary resection. Individualized dietary counseling adapted to regional habits should be considered in long-term transplant follow-up. Larger contemporary series are needed to refine the etiologic spectrum and preventive strategies in this population.

Background and Aims:Virtual reality (VR) distraction techniques are promising adjuncts to reduce pain and anxiety. This study assessed the impact of VR distraction during bedside change of vacuum assisted closure (VAC) dressings. Methods:In this non-blinded randomized superiority trial, patients scheduled for bedside change of a subcutaneous VAC dressing were allocated to receive distraction through VR masks in addition to a standardized pain protocol (intervention) or pain protocol alone (control). Primary endpoints were pain scores assessed by a visual analogue scale (VAS: 0-10), secondary outcomes were anxiety (State Trait Anxiety Inventory (STAI), VAS: 0-10), hemodynamic parameters, and satisfaction (VAS: 0-10). Results:Pre- and postoperative pain levels were 2.2 ± 2.2 versus 2.0 ± 2.1 (p = 0.38) for the intervention group (21 patients) compared with 2.6 ± 2.1 versus 2.2 ± 1.6 (p = 0.26) for the control group (19 patients), with no significant difference between the groups (p = 0.38). No differences between the two groups were observed for blood pressure and heart rate (HR), besides lower post-procedural HR in the intervention group. Anxiety was reduced in both groups post VAC change in the intervention and control group: STAI 40 ± 12 pre-VAC versus 30 ± 8 post VAC and 45 ± 14 pre-VAC versus 32 ± 9 post VAC (both p < 0.01), ∆VAS -2 (interquartile range IQR 0, -3) versus -2 (IQR 0, -5), both p < 0.01. Postinterventional satisfaction was 8.3 ± 1.9 (intervention) versus 7.5 ± 2.4 (p = 0.11). Conclusion:Pain and anxiety were well managed within a standardized pain protocol, with or without adjunct VR distraction. While this may be due to limited statistical power in this exploratory pilot study, further studies should focus on patients with insufficient control of pain and anxiety with a standard protocol to assess the additional value of VR distraction. Trial Registration: study registered in the FOPH portal SNCTP (Swiss National Clinical Trial): NCT04472416.

Objectives:Malignant bowel obstruction (MBO) caused by advanced peritoneal metastases (PM) carries a poor prognosis. Surgical intervention may be the only therapeutic option in selected cases, but operative risks must be carefully balanced against potential benefits. This study aimed to evaluate the outcomes of patients undergoing surgery for MBO secondary to PM. Methods:Single-centre retrospective analysis of consecutive patients operated for MBO of various origins between 2016 and 2021. The primary outcome was overall survival (OS). Secondary outcomes included postoperative morbidity, resumption of systemic chemotherapy, and incidence of re-obstruction. Results:A total of 27 patients (median age 64 years, 67 % female) were included. Median peritoneal cancer index (PCI) was 32, and ascites was present in 16 patients (59 %). Surgical resolution of obstruction was achieved in 24 patients (88 %) via bowel resection (n=10), internal bypass (n=7), stoma formation (n=5), or adhesiolysis (n=2). Severe morbidity occurred in 26 %, with no postoperative mortality. Five patients (19 %) required reoperation, and three (11 %) developed enterocutaneous fistulae. Median OS was 4.0 months (IQR 9.4). Survival rates at 3, 6, and 12 months were 56 , 37, and 26 %, respectively. Postoperative systemic chemotherapy was resumed in 19 patients (70 %), significantly more often among those surviving >6 months (p=0.02). Re-obstruction occurred in 14 patients (52 %). Conclusions:Surgery is a feasible and valid therapeutic option for selected patients with MBO due to advanced PM. Despite considerable morbidity, most patients are able to resume systemic chemotherapy, which may contribute to improved survival outcomes.

Dorsal pancreatic agenesis is an exceptionally rare congenital anomaly involving the partial or complete absence of the pancreatic body and tail. Metabolic dysfunction, including impaired glucose tolerance and insulin-dependent diabetes, is frequently reported; however, the relationship between dorsal pancreatic agenesis and gestational diabetes mellitus has been reported only sporadically. The objective of this report is to present a rare case of dorsal pancreatic agenesis revealed by acute biliary pancreatitis and recurrent gestational diabetes mellitus and to review the relevant literature concerning its metabolic and clinical implications. We report the case of a postpartum woman in her early 30s who presented with acute biliary pancreatitis. Imaging revealed complete agenesis of the pancreatic body and tail, with preservation of the pancreatic head derived from the ventral bud. She had a history of recurrent gestational diabetes, raising the possibility that pregnancy-associated insulin resistance had unmasked a compensated beta-cell deficit due to dorsal pancreatic agenesis. The patient underwent an uncomplicated laparoscopic cholecystectomy with symptom resolution. This case highlights three clinically significant observations: (1) recurrent gestational diabetes mellitus may represent an early clinical clue to reduced pancreatic endocrine reserve in dorsal pancreatic agenesis; (2) acute biliary pancreatitis can incidentally reveal congenital pancreatic anomalies; and (3) structural pancreatic abnormalities should be considered in patients with atypical or recurrent gestational diabetes mellitus. The association between dorsal pancreatic agenesis and gestational diabetes has been reported, albeit rarely, but the interaction between recurrent gestational diabetes mellitus, obesity, and reduced pancreatic endocrine reserve remains insufficiently characterised.

AIM:This study aimed to assess the impact of an institutional teaching program of highly specialized rectal procedures on intra- and early postoperative outcomes. METHODS:We performed a retrospective 10-year cohort study of consecutive patients undergoing low anterior resection (LAR) or abdominoperineal resection (APR) for rectal cancer <12 cm from the anal verge or restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) at a tertiary high-volume academic centre (2014-2023). Procedures were classified as expert (consultant-only) or teaching procedures (performed ≥75% by the trainee under direct supervision). Groups were balanced after 1:1 propensity score matching (PSM) for age, sex, BMI, ASA, Charlson index, neoadjuvant therapy and surgical approach. Primary outcomes were intraoperative surgical adverse events (iAEs, defined according to the Classintra classification) and 30-day complications. Multivariable logistic regression identified predictors of morbidity. RESULTS:A total of 573 surgeries were included (375 expert-led, 198 teaching procedures). After matching, 374 remained (187 per group). IAEs occurred in 16% and 17% of expert-led and teaching procedures, respectively (p = 0.9). Overall morbidity was 43% vs. 46% (p = 0.7); severe complications (Clavien-Dindo ≥ IIIb) occurred in 16% vs. 17% (p = 0.9), while 30-day mortality was 1.1% vs. 0% (p = 0.5). Median length of stay was 8 vs. 7 days (p = 0.6). Reoperation within 30 days occurred in 15.5% in both groups, and readmissions in 16% vs. 10% (p = 0.2). Multivariable analysis revealed high comorbidity indices and immunosuppression as independent risk factors. Robotic surgery was independently associated with lower postoperative morbidity, while teaching was neither associated with overall morbidity (OR 0.60, 95% CI 0.30-1.17) nor severe complications (OR 0.64, 95% CI 0.26-1.48). CONCLUSION:Closely supervised teaching of highly specialized rectal surgery can be safely implemented into clinical practice without increasing perioperative morbidity, supporting the dual mission of surgical proficiency and training of high-volume centres.

BACKGROUND:Enhanced Recovery After Surgery (ERAS) protocols aim to optimize perioperative care and improve recovery after major surgery. While ERAS pathways are well established in several oncologic disciplines, their feasibility and consistency in the setting of cytoreductive surgery, with or without hyperthermic intraperitoneal chemotherapy (CRS ± HIPEC), remain uncertain due to the complexity and heterogeneity of these procedures. METHODS:A prospective multicenter observational study was conducted across 10 expert CRS-HIPEC centers to assess the feasibility and real-world implementation of the ERAS Society guidelines for cytoreductive surgery, with or without hyperthermic intraperitoneal chemotherapy. Perioperative practices were compared before (PRE-ERAS) and after (POST-ERAS) structured ERAS guideline implementation. ERAS adherence, clinical outcomes, and predictors of 90-day postoperative complications and prolonged length of stay were analyzed using multivariable logistic regression models. In addition, a predefined subgroup analysis compared outcomes between ovarian and non-ovarian primary tumors. RESULTS:Between 2021 and 2022, 497 patients were included (PRE-ERAS: 288; POST-ERAS: 209). Baseline characteristics were similar except for more ovarian primaries in POST-ERAS (26.4% vs 44%, p = 0.004). POST-ERAS patients showed higher adherence to anemia screening (60% vs 69%, p = 0.042), carbohydrate loading (4% vs 30%, p < 0.001), and NSAIDs use (26% vs 53%, p < 0.001). Overall ERAS adherence remained stable (median 67%). Complication rates were unchanged, but LOS decreased (13 vs 11 days, p < 0.001) while readmissions increased (11% vs 34%, p < 0.001). Carbohydrate loading (OR 0.29, 95% CI 0.08-0.98, p = 0.048), epidural analgesia (OR 0.39, 95% CI 0.16-0.87, p = 0.025), and >70% ERAS adherence (OR 0.19, 95% CI 0.06-0.54, p = 0.003) predicted fewer complications. Ovarian primary (OR 0.50, 95% CI 0.28-0.87, p = 0.016), >70% adherence (OR 0.33, 95% CI 0.12-0.82, p = 0.025), and POST-ERAS status (OR 0.61, 95% CI 0.37-0.99, p = 0.046) correlated with shorter LOS. CONCLUSION:ERAS implementation for CRS ± HIPEC shortened hospital stay but remained incomplete and was associated with increased readmissions, without reducing complication rates. These findings highlight the need to focus on a pragmatic set of high-impact ERAS elements to improve feasibility in complex cytoreductive surgery.

Introduction Oxaliplatin (Ox) is one of the recommended agents in Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) that benefitted of several phase I trials. Based on these data, the dose of 120 mg/m2 was suggested by an expert consensus for fit patients with peritoneal metastases (PM) of gastrointestinal cancers. The aim of the current study is to determine the real-life feasibility and safety profile of this regimen. Material and methods This retrospective study included all patients treated with PIPAC-Ox 120 mg/m2 in six referral centers specialized in PM. The patients were assessed for all potential toxicities associated to high dose oxaliplatin. Adverse events were expressed with the use of CTCAE for medical complications and Clavien-Dindo for surgical complications. Logistic regression and multivariate analysis were performed. Results 259 PIPAC procedures were performed in 91 patients (53 male) diagnosed with unresectable PM of various origins; most patients (n = 62) having colorectal PM. Concomitant IV 5FU was performed in 70 patients. All patients underwent the first PIPAC-Ox 120 mg/m2, and 44 patients (48.3%) had ≥3 PIPAC. Abdominal pain was the most frequent grade III toxicity at the first PIPAC-Ox (n = 34) while 30 patients routinely received continuous IV opioids. Nausea-vomiting and ascites infection were the others grade III toxicity observed at PIPAC 1, one in each case respectively. After PIPAC 3, RECIST partial/stable response in 68.2%; PRGS 1-2 in 77.3% and negative cytology in 50% of patients. Conclusions High-dose PIPAC-Ox is feasible and safe. Local and histological response are well identified. However abdominal pain remains a main concern and continuous IV protocols should be considered routinely.

Introduction: Crohn’s disease (CD) remains associated with long-term morbidity despite biologic therapies. Surgery, historically considered a last-resort option, is increasingly integrated into disease management earlier. This review examines the evolving role of surgery in the biologic era. Methods: A focused narrative review of randomized controlled trials, meta-analyses, observational studies, and international guidelines addressing contemporary surgical strategies in CD was performed. Results: The LIR!C trial demonstrated that early ileocecal resection provides durable remission and improves long-term outcomes compared with biologic therapy in selected patients. The PISA II trial supported an early combined surgical and medical approach for perianal fistulizing disease. Preoperative optimization, including nutritional support and adjustment of immunosuppressive therapy, has become a cornerstone of perioperative management. Laparoscopic surgery remains the preferred approach whenever feasible, while robotic surgery is emerging as a promising platform that is expected to play an increasingly important role in the surgical management of CD. Postoperative recurrence remains a major challenge, prompting the development of innovative surgical strategies. Although the Kono-S anastomosis initially showed promising reductions in recurrence, recent prospective studies failed to confirm superiority over conventional techniques. Similarly, extended mesenteric excision did not demonstrate improved outcomes despite increasing evidence implicating the mesentery in CD pathogenesis. Strictureplasty remains an effective option for selected fibrotic small-bowel strictures. Conclusions: Surgery remains central to multidisciplinary CD management and offers the potential to modify disease when performed early in selected patients. The impact of innovative surgical strategies on postoperative recurrence remains uncertain, and ongoing trials are expected to further help with surgical decision-making.

Background Enhanced Recovery After Surgery (ERAS) protocols have markedly improved outcomes after colorectal and other major surgery, suggesting benefits also for complex surgeries like Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC). This study investigates the adoption and acceptance of the recent ERAS recommendations for CRS-HIPEC within expert centers. Methods Clinicians from 16 expert centers across 9 countries were invited to answer an online survey inquiring about current clinical practice. Adoption of the 72 ERAS items from the recent dedicated guidelines were evaluated using a Likert-type scale with focus on preoperative, perioperative, and postoperative phases. Results Overall, 27 clinicians (11 female, 21 surgeons, 2 gynecologists and 4 anesthesiologists/intensivists) participated, with high adoption of ERAS protocols at baseline (67 %). More than half of the guideline items (54 %) were widely adopted. However, despite nearly 18 % intending to change their practices, there remains substantial resistance to further adoption, such as for measures like alcohol cessation programs, mechanical bowel preparation, and oral antibiotic decontamination. Barriers identified include resource limitations(20 %), perceived irrelevance (17 %) for specific patient groups, unclear benefits (59 %), and restrictive policies (5 %). Conclusion The study shows that most ERAS principles are routinely implemented in CRS-HIPEC surgeries, despite significant challenges with specific components and complex processes. Future research will focus on generating additional evidence and streamlining ERAS guidelines to prioritize essential elements.

In 2012, the Department of Visceral Surgery of the Lausanne University Hospital CHUV implemented a dedicated high-resolution anoscopy (HRA) outpatient clinic for surveillance and follow-up purposes. This 10-year longitudinal study analyzed 537 patients (2214 visits) using a structured screening protocol. Dysplastic lesions were detected in 49% of patients, predominantly low-grade squamous intraepithelial lesions (LSILs, 74%). Among LSIL cases, 6% progressed to high-grade squamous intraepithelial lesions (HSILs) within 24 months, reaching 25% cumulative progression at 36 months. Of HSIL patients, 3% developed carcinoma in situ after 48 months. Notably, no invasive carcinoma was observed during the follow-up. Four patients diagnosed with squamous cell carcinoma at initial screening were treated with chemoradiotherapy, and one required salvage surgery. Independent risk factors for the presence of higher-stage precancerous lesions (≥HSILs) were the presence of high-risk HPV genotypes (OR 14.5, 95% CI 5-42.2, p < 0.001), detectable HIV viral load (OR 5.4, 95% CI 1.8-16.7, p = 0.003), and symptoms at the first screening visit (OR 3.2, 95% CI 1.1-9.9, p = 0.04). HIV-positive status was associated with a trend towards an increased risk of progression (OR 2.79, p = 0.073). These findings highlight the importance of systematic follow-up and early intervention in high-risk populations to prevent anal cancer progression.

BACKGROUND:In patients with colorectal cancer and peritoneal metastases (CRC-PM), the completeness of cytoreductive surgery (CRS) is crucial. However, a history of moderate (Prior Surgical Score, PSS-2) or extensive (PSS-3) abdominal surgery may compromise the exploration, increasing the risk of undetected CRC-PM. This retrospective monocentric study investigated the value of preoperative peritoneal magnetic resonance imaging (MRI) in identifying potentially occult lesions in patients with PSS-2/3 CRC-PM scheduled for CRS. PATIENTS AND METHODS:Consecutive patients with pathologically confirmed CRC-PM and PSS-2/3, selected for radical treatment, were included. All underwent preoperative peritoneal MRI ≤ 7 days before CRS, between January 2015 and December 2020. MRI, surgical, and pathological reports were reviewed focusing on seven anatomical sites of interest (perihepatic, pelvic, retroperitoneum, abdominal wall, anastomosis, inguinal canal, and cardiophrenic space). RESULTS:Overall, 248 patients were included; 242 (97.6%) underwent complete CRS (CC-0). Among them, 212 (85.5%) were PSS-2 and 36 (14.5%) PSS-3. The sensitivity, specificity, and accuracy of MRI in detecting lesions were, respectively, 65%, 91%, and 82% (perihepatic region); 53%, 81%, and 63% (pelvis); 41%, 91%, and 69% (retroperitoneum); 46%, 91%, and 79% (abdominal wall); and 44%, 98%, and 74% (anastomotic sites). In the inguinal canal and cardiophrenic space, preoperative MRI led to ten resections in ten patients, with neoplastic cells detected in eight cases (80%). CONCLUSIONS:Preoperative peritoneal MRI demonstrated good specificity and a promising negative predictive value (NPV) but modest sensitivity in detecting lesions across seven anatomically challenging regions. Further studies are warranted to better define its added value over standard preoperative imaging protocols.

Colorectal DiseaseEarly View VIDEO CORRESPONDENCE How I do it: a standardized approach to robotic-assisted oncological sigmoid resection – a video vignette Héloïse Giron, Héloïse Giron Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland Contribution: Writing - original draftSearch for more papers by this authorAmaniel Kefleyesus, Amaniel Kefleyesus orcid.org/0000-0002-7951-4041 Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland Contribution: Writing - review & editingSearch for more papers by this authorDavid W. Larson, David W. Larson Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA Contribution: SupervisionSearch for more papers by this authorFabian Grass, Corresponding Author Fabian Grass [email protected] orcid.org/0000-0001-9884-2879 Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland Correspondence Fabian Grass, Department of Visceral Surgery, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland. Email: [email protected] Contribution: Supervision, Writing - review & editingSearch for more papers by this author Héloïse Giron, Héloïse Giron Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland Contribution: Writing - original draftSearch for more papers by this authorAmaniel Kefleyesus, Amaniel Kefleyesus orcid.org/0000-0002-7951-4041 Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland Contribution: Writing - review & editingSearch for more papers by this authorDavid W. Larson, David W. Larson Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA Contribution: SupervisionSearch for more papers by this authorFabian Grass, Corresponding Author Fabian Grass [email protected] orcid.org/0000-0001-9884-2879 Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland Correspondence Fabian Grass, Department of Visceral Surgery, Lausanne University Hospital CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland. Email: [email protected] Contribution: Supervision, Writing - review & editingSearch for more papers by this author First published: 19 January 2024 https://doi.org/10.1111/codi.16881Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Open Research DATA AVAILABILITY STATEMENT Data sharing is not applicable to this article as no new data were created or analyzed in this study. REFERENCE 1Abd El Aziz MA, Grass F, Behm KT, Shawki S, D'Angelo AL, Mathis KL, et al. Trends of complications and innovative techniques' utilization for colectomies in the United States. Updates Surg. 2020; 73: 101–110. 10.1007/s13304-020-00862-y PubMedWeb of Science®Google Scholar Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

BackgroundCytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment for peritoneal metastases. However, HIPEC with cisplatin is associated with renal toxicity. Sodium thiosulfate (ST) has been shown to prevent cisplatin-induced toxicity.MethodsA retrospective, single-center analysis of patients treated curatively for peritoneal surface malignancy, who underwent cytoreductive surgery with cisplatin-based HIPEC between 2015 and 2020. Patients were categorized into three groups based on the management of cisplatin-induced renal toxicity: preoperative hyperhydration alone (PHH), preoperative hyperhydration with ST (PHH + ST), and ST alone. Renal function and complications, in terms of Acute (AKI) and chronic kidney injury (CKI), were monitored and analyzed during 3 postoperative months.ResultsThis study included 220 consecutive patients. Mean serum creatinine levels were 95, 57 and 61 mmol/L, for PHH, PHH + ST and ST groups, respectively (p < 0.001). Glomerular Filtration Rate (GFR) were 96, 94 and 78 ml/min/1.73 m2, respectively (p < 0.001). AKI and CKI are respectively for PHH, PHH + ST and ST groups were 21 % (n = 46), 1 % (n = 2) and 0 % vs 19 % (n = 42), 0 % and 0 % (p < 0.001), for pairwise analysis did not show any difference between PHH + ST and ST alone combination, regarding nephrological outcomes. All patients were followed 3 months postoperatively.ConclusionThere is no need for preoperative hyperhydration when sodium-thiosulfate is used to prevent cisplatin-induced nephrotoxicity in patients undergoing cytoreductive surgery with HIPEC. These findings have implications for improving and simplifying the management of patients with peritoneal metastases undergoing HIPEC with cisplatin.

Le kyste sacro-coccygien est une maladie fréquente chez les jeunes adultes, caractérisée par une infection chronique de la région du coccyx. Parmi les options de traitement disponibles, il est important que l’intervention chirurgicale soit la moins invasive possible. Les soignants jouent un rôle important dans les suites postopératoires, notamment en matière de soins de plaies et de prévention des infections du site opératoire.

Selected patients with colorectal cancer peritoneal metastases (CRPM) could be offered a curative-intent strategy based on complete cytoreductive surgery (CRS), potentially combined with hyperthermic intraperitoneal chemotherapy (HIPEC) and perioperative systemic chemotherapy. The impact of different neoadjuvant systemic chemotherapy (NACT) regimens remains unclear due to a lack of comparative data. Consecutive CRPM patients from a monocentric database who were treated with complete CRS after single-line NACT were included in this study. Chemotherapy regimens were tailored as a doublet drug (FOLFOX/FOLFIRI) with/without targeted therapy (anti-epidermal growth factor receptor/bevacizumab) and triplet-drug combination (FOLFIRINOX). Morphological response (MR) was assessed using the Response Evaluation Criteria in Solid Tumors criteria, and pathological response (PR) was assessed using the Peritoneal Regression Grading Score (PRGS). Long-term oncologic outcomes were compared. The cohort comprised 388 patients, including 127, 202, and 59 patients in the doublet, doublet + targeted, and triplet groups, respectively. MR rates were higher in the triplet (68.0